When my business partner, Brian Bartholomew, and I began to
support our elderly parents some years ago, we became acutely
aware of a national phenomenon: the aging of America. Today,
people aged 80 and older are the fastest-growing segment of the
population. Members of our own generation — the baby
boomers — are quickly becoming eligible for those
discounted early dinners at buffet restaurants. Even in our
relatively youthful 50s and 60s, many of us are beginning to
experience the realities of aging, from hip and knee
replacements to hearing and vision impairments.
Clearly, all of this puts new demands on the home environment.
Yet it seemed to Brian and me that the average senior's home
was a much-neglected factor in the aging equation.
Increasingly, seniors want to "age in place," meaning they want
to live out their lives in their own homes, rather than in a
facility. Often this presents a variety of "built environment"
challenges, from minor adaptations to major modifications.
Because few remodeling companies in our area were addressing
those needs, we founded In Your Home to help this growing
Remodelers interested in this specialty need to develop a
heightened awareness of the common effects of aging. Vision,
hearing, strength, and balance tend to decline. The ability to
handle temperature extremes decreases; thermal comfort becomes
a major concern. These changes affect a home's design and drive
the selection of materials and fixtures.
Resources are available. Two good places to start are NAHB's
CAPS (Certified Aging-in-Place Specialist) training and the
National Resource Center on Supportive Housing and Home
Modification's online courses. (For contact information —
and further resources — see the sidebar below). We've
participated in both programs.
When we first started our company, we expected that the bulk of
the work would center around safety modifications like access
ramps and grab bars. And indeed, they are a core element of our
But there's more to the aging-in-place market than making
accessibility modifications. Since our entire mission is based
on supporting mature clients who — like all of us —
want to be comfortable and secure in their homes, we also do
plenty of business simply helping to create and maintain nicer
spaces in which to live. That covers everything from providing
a fresh coat of paint and new work surfaces to installing
Just because seniors deal with issues of frailty doesn't mean
they throw comfort and aesthetics out the window. Many a client
has opened a discussion with the words, "I don't want it to
look like a darn nursing home around here!"
Accessible entries can be as simple as a
long, gently sloping surface (bottom left) or a series of small
height transitions (top). On occasion it may be necessary to
use a mechanical lift, like this one from Ram Manufacturing
Preserving the Home's Value
Many homeowners are concerned about the effect modifications
will have on real estate value. Our clients often ask us
whether an accessible bath, say, or a ramp will add or detract
from their home's value.
Whenever possible, of course, we add value. With some kinds of
modifications, though, this just isn't possible, so we try to
make these alterations in such a way that they won't be
A ramp project, for instance, can be a modular design that
doesn't require permanent footings, making it easier to remove
when the time comes. (For a good primer on ramp construction,
see the Web-resources listing in the sidebar below.)
In one case — a bathroom remodel — we replaced an
old claw-foot tub with a barrier-free shower. The new shower
partially obscured a window, and the installation didn't
complement the style of the 1920s-era home. But the new unit
was sturdy and economical, so we — along with the client
— made a deliberate decision to place function ahead of
aesthetics. We expect that when the home is sold in the future
the bathroom will be redone.
Getting the client into the home safely and conveniently is a
good starting point for any design.
While we do sometimes build wood ramps for access, the solution
is often simpler. For example, we can replace one-step
transitions at the front entrance with several feet of gently
sloping concrete, or use a series of small height transitions
into the house.
There are times, however, when those strategies just don't fit,
and then we install an exterior mechanical lift (Trus-T-Lift,
Ram Manufacturing, 800/563-4382,
Safety and Comfort Inside
Since most seniors experience some loss of vision and increased
sensitivity to temperature, these issues — in addition to
accessibility — guide much of our work.
When we redo a room, we look for ways to improve lighting and
provide color contrast; our goal is to make the space both
easier to navigate and more stylish. For example, we use color
to set up a distinct contrast between wall and floor, and
contrasting elements like chair rails and baseboards to make
the room's edges more visible.
Borrowing space from an adjacent room is
a good — though expensive — way to enlarge a
kitchen. The existing galley kitchen shown here (left) had a
tight passage door and little room to maneuver a wheelchair.
The remodeled version (below) accommodates the required 5-foot
turning radius plus plenty of extra space for a second
Another approach is to create flooring inlay patterns that
outline major pathways. We frequently highlight countertop
edges with contrasting strips of color, too; we steer clear of
single-color decorating schemes that can confuse depth
perception and invite accidents. In fact, many of our customers
prefer more intense paint colors; as we age, our eyes lose
sensitivity to color, especially in the blue spectrum.
Glare can be disorienting for people with cataracts or
glaucoma, so we avoid glossy counter surfaces.
Sometimes we lay laminate flooring in the kitchen and hallways;
its smooth, hard surface is easy to navigate with a walker or
in a chair. In living rooms and bedrooms, we may use a low-nap,
stain-resistant carpet over a thin pad. We like the BerberMax
pad (Leggett & Platt, www.lpurethane.com), which has the added
advantage of repelling moisture and resisting mildew.
Pull-out storage is an essential part of
a wheelchair-accessible kitchen; thanks to the upgrade, this
kitchen is more convenient for everyone — seated and
standing — to use.
If a resident uses a wheelchair, we make sure to evaluate
sightlines from a seated perspective; sometimes we'll end up
reorienting lighting fixtures to eliminate glare, or we'll
lower a window's location to improve operation and the view
outside. Adding skylights is a good way to increase natural
We commonly install remote-control ceiling fans in bedrooms and
sitting areas; these are easy for homeowners to operate from a
chair or bed.
To improve general navigability throughout the house, we
replace existing round doorknobs with levers. Sometimes we'll
replace wall switches with Decora-style rockers lighted for
nighttime safety. Both changes, though minor, are of real
benefit to people with arthritic hands.
Thermal comfort. Since many older houses are drafty and
underinsulated, we may add insulation or even tighten the
On one recent project, for instance, we replaced old '70s-era
fixed aluminum windows with operable vinyl units. In the living
room, we tore out a drafty masonry fireplace and installed a
thermostatically controlled gas model. The home already had air
conditioning, but we increased the ceiling insulation to R-49
to mitigate the effect of a hot summer attic.
The kitchen is always a main focus of our work, especially for
any client who uses or foresees using a wheelchair.
Typically in older homes the door into the kitchen is too
narrow, and there's often not enough room in the kitchen itself
to turn a wheelchair. While modern power chairs can turn on a
dime, accessible-design guidelines still prescribe a 5-foot
turning radius. Plus, keep in mind that there's frequently more
than one person working in the kitchen.
The author has found that a rolling work
surface (left) adds great versatility to the kitchen.
Side-swinging oven doors (right) are easier to operate from a
wheelchair than bottom-hinged doors.
Consequently, we often have to find floor space, either by
removing cabinets or stealing additional space from adjacent
rooms. Unfortunately, the added space can be costly and is
unlikely to add equivalent value to the home. Still, because
the kitchen is the center of the home's activities, the expense
is usually acceptable to the client.
Along with adding open floor space, we improve the lighting
— both undercabinet and overhead — and add
accessible pull-out cabinet storage, which is easier for both
seated and standing residents to use.
We also like to install side-swing wall ovens. With these
units, there is no need to bend over to reach inside, and the
side-swing door is relatively effortless to operate. Frigidaire
makes a well-priced unit; other manufacturers offer similar
models at higher cost.
We have found that a modified off-the-shelf kitchen cart is
great for transporting hot or heavy pots across the kitchen or
to the dining table; the cart also serves as a handy work
surface that can be tucked away in the cabinetry when not
The bathroom is potentially the most dangerous room in the
house for the elderly, so we concentrate on safety features
The author pulls old bathtubs and
installs low-threshold shower units like this one from Best
Grab bars. We install grab bars as a matter of course, always
adding blocking if we have access to the wall cavity. When
consulting with clients, I often liken grab bars in the
bathroom to seatbelts in cars; back in the early '60s,
seatbelts were an option that many folks took a rather dim view
of. Now you can't buy a car without them.
Similarly, grab bars may signal frailty to some, but in reality
they provide common-sense support for people of all ages.
Furthermore, these days they can be flawlessly integrated into
the decor, thanks to modern materials and designs.
Solid blocking makes it easy to mount
safe, secure grab bars, which benefit people of all ages and
belong in all bathrooms.
On one of our jobs, the clients insisted on keeping the regular
towel bars in the bath used by their elderly father.
Predictably enough, they called a year later to say their dad
had pulled one loose while using the toilet; they asked us to
replace them with real grab bars.
Accessible shower. Even with the addition of grab bars, many
elderly folks are not able to step over the sides of
traditional tubs, so we frequently replace tubs with
low-threshold shower units from Best Bath (800/727-9907,
www.best-bath.com). We find these units
easy to install on a remodel and we like their layered
construction, which allows seats and bars to be attached
We seldom install standard-height toilets anymore; everybody
— young and old — appreciates comfort-height units,
which are about 2 inches taller than the traditional johns,
because they're easier on the knees. We have installed a range
of models from Toto, Kohler, American Standard, and Eljer, to
fit budgets and design preferences.
For better traction, we treat bath tiles with No Skidding
coating (800/375-0571, www.noskidding). This product is easy to
apply and actually has a greater friction coefficient when it
Undertile electric radiant heating is a good fit on many of our
jobs; tile can feel cold in any climate, and this is an
economical way to add comfort.
Occasionally we'll have to work on the framing to make it easy
to enter the bathroom in a wheelchair. We try to do this as
inexpensively as possible, borrowing from nearby space as
needed. A 3/0 pocket door makes for easy passage.
Don't Forget Storage
Major storage areas are crucial for people downsizing from a
larger home, so we'll add lots of shelving where we can. An
attached garage is ideal for this, but we'll also look for
other places to tuck accessible storage.
On one job, we enhanced the garage storage by applying a
no-slip coating to the slab, Rust-Oleum's AS5400 System
Anti-Slip One-Step Pedestrian Epoxy (800/323-3584,
Readily accessible storage is always a plus for seniors. The
author tucks shelves wherever he can, as in this hallway
laundry closet (top). He also makes good use of attached
garages. Here, the addition of shelving, good lighting, and a
slip-resistant epoxy dramatically improved the space
As both homeowners and remodelers start paying more attention
to universal design principles and taking note of all the
advantages that come with aging in place, I have no doubt we'll
continue to discover better ways to design and construct
senior-friendly housing. And the more our industry adopts a
mind-set conducive to aging in place, the better and more
permanent our homes will become.David
Dickinsonis a principal partner
of In Your Home, a Portland, Ore., remodeling company that
specializes in the aging-in-place market
For More Information
NAHB's CAPS (Certified Aging-in-Place Specialist)
program, 800/368-5242, www.nahb.org
National Resource Center on Supportive Housing and Home
Modification online courses, 213/740-1364,
Online courses (see above); news; directory of
home-modification programs and such resources as safety
checklists and product listings
Downloadable documents, including house plans, ramp designs,
and "simple solutions"
Checklists and sections on modifications for bathrooms,
walkways, and kitchens
Articles on ramp design and a manual of design and construction
for modular wheelchair ramps
Articles on home modification with an emphasis on safety and
General site focused on preventing falls
Site for seniors; includes a section on housing options